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Romney proposal underscores importance of public trust in public health

Written by Derek Monson

July 29, 2022

Utah Sen. Mitt Romney was in the news this week after proposing legislation to create a new federal public health agency – the Center for Public Health Data (CPHD). The center’s purpose would be to help the United States “better prepare for and potentially prevent major outbreaks” of future pandemic diseases by being a source of “reliable, real-time data” on public health for policymakers, researchers, the media, and the general public.

The CPHD is intended to be a step removed from politics and partisan divisions over things like public health mandates because it lacks any regulatory or policymaking authority. It would only provide up-to-date information about public health and the spread of disease to anyone who asks for it.

Given the public trust problem of the institutions of public health (and civic institutions generally), a proposal for a new, data-focused public health agency is a constructive step forward. On the other hand, a barrier to its success might be the public trust problem.

The trust gap

A new illustration of that problem was highlighted recently by a recent Deseret News article on vaccination rates among young children who are newly eligible for the COVID-19 vaccine. According to a national news source quoted in the article, “in the three weeks following the authorization of vaccines for the 5-to-11 age group, 15% of that population had received at least one shot, compared with 2% of the 6-months-to-5-years group.”

The article concludes that “if Americans trusted public health officials, we’d see more than 2%-3% of parents following their recommendations on COVID-19 vaccination for children 5 and younger, and more than a third of American parents fully vaccinating their 5-to-11-year-olds.” This makes sense.

How the CPHD might help

Having a public health agency like CPHD devoted to putting out reliable information might help rebuild some public trust in the institutions of public health. If the agency focuses solely on helping policymakers and the public better understand public health dynamics and realities, it could serve as a reminder that the purpose of public health institutions is to help Americans become and remain healthy physically, mentally and otherwise.

It helps in this regard that CPHD is, as we mentioned, theoretically removed from controversy because it lacks the regulatory or policymaking authority that is vested in other public health agencies such as the CDC and FDA. However, if the CPHD is structured poorly or is managed such that it primarily focuses upon information to buffer federal public health agencies from accountability or to sell particular public health policies, then it will squander the opportunity to improve public trust in public health institutions.

In other words, to apply the thinking of American Enterprise Institute scholar Yuval Levin, the only way for CPHD to help the public trust problem is if it bolsters its leadership and members against political pressures such that they act in a trustworthy manner in the eyes of the American people. If CPHD leaders simply perform a role in a political narrative designed to benefit a presidential administration or policy agenda, then it is unlikely to help rebuild trust in public health.

Will the public give CPHD a ‘honeymoon’?

For an information-focused federal agency to be successful at informing Americans and their elected leaders, it has to have some basis of public trust to be credible with Americans. But – back to the initial problem – public trust is what public health institutions are lacking.

If that trust problem immediately spills over to CPHD, it could become a significant barrier to CPHD’s chances of success right out of the gate. On the other hand, it is plausible that a new public health institution might be given something of a grace period by the American people and/or policymakers – akin to the presidential “honeymoon period” – wherein it can solidify its trustworthiness.

Conclusion

Whether the newly proposed CPHD – assuming enacting legislation can pass Congress – will help or be hindered by the level of public trust in institutions of public health remains an open question. It seems likely that, if it is structured correctly, CPHD will have the chance to improve that trust.

But much of the answer will only come by seeing how the proposed agency is implemented and administered, should it eventually get created. The potential is there. But to see that potential fulfilled and public trust in public health restored will require elected officials and public health leaders willing to place the interest of Americans in future pandemics first and foremost – even ahead of partisan or personal career interests, should it come to a choice of one or the other. It will also require the American people to be willing to accept information that may not fully reinforce – and may even clearly contradict – some of their political or partisan commitments.

All of this will be an uphill climb, but it is worth attempting. If we get it right, both the health and freedom of our own and future generations will prosper from these efforts.

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